Individual provider Active NPI

William T Sumner, MD

  • Procedural Dermatology Physician
  • Concord, NC
National Provider Identifier
1871579110
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
97-01610 Issued in NC
Practice address
335 Penny LN
Concord, NC 28025-1221
Phone
(704) 784-5901
Fax
(704) 721-0413
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 97-01610 NC Primary

Addresses

Primary practice location

335 Penny LN
Concord, NC 28025-1221

Mailing address

335 Penny LN
Concord, NC 28025-1221
Phone (704) 784-5901

Other identifiers 2

IdentifierTypeStateIssuer
70014625OtherNCMEDICARE RAILROAD
89126J2MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101006000868 NC Practitioner - Dermatology 1153513361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Duke University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group of the CarolinasGroup PAC ID 3678514759, 24 clinicians

Practice addresses (Care Compare)

335 Penny LN
Concord, NC 28025-1221
Phone (704) 784-5907

Merit-based Incentive Payment System (MIPS)

Final score
85.93 of 100Reported as group
Quality
69.47
Promoting interoperability
100
Improvement activities
40
Cost
83.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision49
Removal of tissue1-10
Removal of skin lesions1091
Removal or shaving of skin growth1-10
Skin biopsy233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
97-01610NCMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Group of the Carolinas Dermatology CurrentSince Sep 13, 2010 Accepting new patients

Locations

335 Penny Ln
Concord, NC 28025
Phone (704) 784-5901

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1871579110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901",
            "fax_number": "704-721-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901",
            "fax_number": "704-721-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "WILLIAM",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NC",
            "license": "97-01610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "70014625",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126J2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.